Methylphenidate Based
Medication | Form | Dose/Schedule | Dose Range | Onset/Duration | Most Common Side Effects |
Pro | Precautions |
Methylphenidate (MPH) Ritalin Methylin |
tablets IR 5, 10, 20 mg chewable IR 2.5, 5, 10 mg liquid IR 5 mg/5ml 10 mg/5ml |
Usually given two or three times a day. Begin 5 mg early AM & noon. |
Child: 5-45 mg Adoles: 10-60mg Adults: 20-80mg |
onset: 15-20 min duration:4 hrs max |
Decreased appetite, decreased sleep, less common: headaches, stomach aches, irritability, weight loss, tics, “rebound”. Can overstimulate or make too calm if dose is too strong. These are true for all stimulants listed on the first two chartsSame as above. |
EVERY MEDICINE ON THIS TABLE IS (MPH) METHYLPHENIDATE BASEDMethylphenidate is the generic name of all these. Works quickly, effective often. The most studied. Little to no lab testing needed. Good safety history. Methylin has no dye, is very small, and comes in grape chewable and liquid. Focalin is a refined isomer form which may be better tolerated and smoother. |
Caution if history of tics or Tourette’s or high blood pressure or heart problems. Controlled substance. Must hand write all scripts, no refills, no call ins. True for all stimulants listed on the first two chartsSome kids get “meaner” with stimulants, especially amphetamines listed on second chart. |
Focalin (dexmethylphenidate)Focalin XR |
tablets IR 2.5, 5, 10mgFocalin XR comes in 5, 10, 15, 20, 25, 30, 35, 40mg |
Focalin: 4-5 hrs.
Foclin XR: 8 hrs. |
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methylphenidate-SR
Ritalin-SR Methylin ER Metadate ER |
tablets 10mg SR 20mg SR10mg ER 20mg ER |
Begin 10 or 20mg SR in AM, may need increase or noon dose. May need regular Ritalin to start in AM or extend duration to PM. All 4 of these are time release capsules. |
Child: 10-40 mg Adoles: 20-40 mg Adults: 20-80 mg |
onset: 30-60 min duration: 5-8hrs |
These are longer lasting versions of methylphenidate. Avoids noon dose, usually. Concerta is a methylphenidate in a clever osmotic pressure release mechanism pill. Metadate CD uses a third mechanism to extend the duration and smooth the effect of methylphenidate. Metadate CD, Ritalin LA, Aptensio XR, and Focalin XR capsules can be pulled apart and sprinkled on food. Quillivant is a time release liquid while Quillichew is a chewable time release pill. Daytrana is a skin patch.Metadate CD is 30% IR + 70% ER Ritalin LA is 50% IR + 50% ER |
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Concerta ER |
18, 27, 36, 54mg |
Once a day in AM. |
Child: 18-27mg Adoles: 27-54mg Adult: 36-72mg |
onset: 15-30 min duration: 8-10 hrs. |
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Metadate CDRitalin LA |
10, 20, 30, 40, 50, 60mg CD capsule10, 20, 30, 40mg capsules |
These 2 are time release capsules.Start 10-20mg AM Give once a day in AM Max is 60mg/d |
Child: 10-40mg Adoles: 20-40mg Adult: 20-60mg |
onset: 30 min. duration: 6-8 hrs. |
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Quillivant XR Quillichew ER |
Liquid suspension 25mg/5ml (5mg/1ml) Chewable tablets 10, 20mg scored 40mg is not scored |
Once a day in AM |
10mg/d = 2 ml20mg/d = 4 ml30mg/d = 6 ml40mg/d = 8 ml50mg/d = 10 ml Child: 10-40mg Adoles: 10-60mg Adult: 10-60mg |
onset: 30 min duration: 8-12 hrs.onset: 30-60 min duration: 8-12 hours |
Same as above. |
The only time release liquid stimulant.The only chewable extended release ADHD med. Releases biphasic 30% IR + 70% ER |
Comes as powder in bottle, add water, shake vigorously before each use. Refrigerate. Use dropper to measure.Brand only – 2014New formulation 2016 Brand only |
Aptensio XR | capsule 10, 15, 20, 30, 40, 50, 60mg |
Once a day in AM Start 10 mg |
Child: 10-40mg Adoles: 10-60mg Adult: 10-60mg |
onset: 30-45 min duration: 8-12 hours |
Same as above. | Another capsule option. Can be sprinkled on food. 40% immediate (IR) and 60% delayed release. |
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DAYTRANA (methylphenidate transdermal system) |
patch 10, 15, 20, or 30 mg/9 hours |
One patch per day to hip in early a.m. Remove after 6 to 12 hours – 9 hours is advised. |
Child: 10-20mgpatchAdoles: 15-30mgpatchAdult: 15-30mg |
onset: 2 hoursduration: 1-2 hours after patch removed |
Same as above plus patch may irritate skin.
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Although not designed to be cut, patch can be cut to lessen dosage. Avoids oral dosing. Should cover school day and longer. Duration can be adjusted by time patch is put and removed. May be smoother. Patch can be removed early to shorten duration. |
Slow onset.Patch may come off accidentally. Patch may rarely lastingly discolor skin. Even low dose patch may be too strong for a child. Brand only. |
Simultaneous use of alcohol or cigarettes and especially street drugs should be avoided. All medications should be avoided if possible in pregnancy. This chart is intended to be a summary guide, not a full and complete list.